Traumatic brain injury rehabilitation, the programs applied in French UEROS units, and the specificity of the Limoges experience.

First created in 1996, the French evaluation, retraining, social and vocational orientation units (UEROS) now play a fundamental role in the social and vocational rehabilitation of patients with brain injury. As of today, there exist 30 UEROS centers in France. While their care and treatment objectives are shared, their means of assessment and retraining differ according to the experience of each one. The objective of this article is to describe the specific programs and the different tools put to work in the UEROS of Limoges. The UEROS of Limoges would appear to offer a form of holistic rehabilitation management characterized by the importance of psycho-education and its type of approach towards vocational reintegration.

Preliminary questions before studying mild traumatic brain injury outcome.

OBJECTIVES: To point out from the literature the issues in mild traumatic brain injury outcome. METHODOLOGY-RESULTS: The literature review allows to point out several different factors involved in the difficulty to study mild traumatic brain injury: mild traumatic brain injury definition, postconcussional syndrome definition, diagnosis threshold, severity and functional symptoms outcome, neuropsychological tests, unspecific syndrome feature, individual factors, confounding factors and treatment interventions. DISCUSSION-CONCLUSION: The mild traumatic brain injury outcome study is complicated by the definitions issues and especially their practical use and by the multiplicity and the intricate interrelationships among involved factors. The individual outcome and social cost weight is widely emphasized for an event still considered as medically trivial. The well-ordered preventive interventions necessity and the targeted treatment programs need for the persisting postconcussive symptoms complete our critical review.

[French version of structured interviews for the Glasgow Outcome Scale: guidelines and first studies of validation]. / Version française de l'entretien structuré pour l'échelle de devenir de Glasgow (GOS): recommandations et premières études de validation.

OBJECTIVES: The Glasgow Outcome Scale (GOS) is the most widely used outcome measure after traumatic brain injury. The GOS's reliability is improved by a structured interview. The two aims of this paper were to present a French version of the structured interview for the five-point Glasgow Outcome Scale and the extended eight-point GOS (GOSE) and to study their validity. METHODS: The French version was developed using back-translation. Concurrent validity was studied by comparison with GOS/GOSE without structured interview. Inter-rater reliability was studied by comparison between assignments made by untrained head injury observers and trained head injury observers. Strength of agreement between ratings was assessed using the Kappa statistic. RESULTS: The French version and the guidelines for their use are given in the Appendix. Ratings were made for 25 brain injured patients and 25 relatives. Concurrent validity was good and inter-rater reliability was excellent. CONCLUSION: Using the structured interview for the GOS will give a more reliable assessment of the outcome of brain injured patients by French-speaking rehabilitation teams and a more precise assessment with the extended GOS.